Acid-Base, Fluid & Electrolytes
Answers are provided below each question

  1. In humans, the thirst center is located in the:
    1. Adrenal cortex
    2. Pons
    3. Hypothalamus
    4. Medulla Oblongata
    5. Thalamus

  2. The longer the ___________________, the greater an animal's capacity to conserve water and to concentrate the solutes excreted in the urine.

  3. Hormonal control of urinary excretion primarily affects:
    1. Bowman's capsules
    2. DCTs and collecting ducts
    3. PCTs and Loops of Henle
    4. Urinary Bladder

  4. The chief extracellular cation is ____________________.

  5. The chief intracellular cation is ___________________.

  6. The chief extracellular anion is ___________________.

  7. The chief intracellular anion is ____________________.

  8. As dehydration increases, the release of ADH from the posterior pituitary will ___________________.

  9. The plasma protein concentration of a patient with untreated glomerulonephritis would be expected to be:
    1. Greater than normal
    2. Less than normal
    3. Normal

  10. Which of the following is NOT a function of atrial natriuretic peptide?
    1. It acts to decrease aldosterone release from the adrenal cortex
    2. It acts to increase urine output
    3. It acts to increase blood pressure
    4. It acts to decrease ADH release

  11. Parathyroid hormone acts to:
    1. Decrease calcium absorption in the gut
    2. Decrease calcium reabsorption in the renal tubules
    3. Increase plasma calcium levels
    4. Increase osteoblast activity

  12. 7.0 is the normal pH of the:
    1. Blood in the renal artery
    2. Blood in the testicular vein
    3. Urine
    4. Fluid within a typical cell

  13. The addition of a strong acid to the extracellular fluid would result in the increased formation of:
    1. NaHCO3-
    2. H2CO3
    3. OH-
    4. All of the above

  14. Which of the following depends on the presence of electrolytes?
    1. Membrane polarity
    2. Neuromuscular excitability
    3. Maintenance of osmotic relations between cells and ECF
    4. All of the above

  15. Plasma is considered to be:
    1. Extracellular
    2. Intracellular
    3. Interstitial
    4. Lymph

  16. The term alkaline reserve is used to describe the ____________ buffer system.
    1. Phosphate
    2. Hemoglobin
    3. Bicarbonate
    4. Protein

  17. In an attempt to compensate for plasma acidosis:
    1. Breathing rate and depth will increase
    2. Breathing rate and depth will decrease
    3. Breathing rate will increase and depth will decrease
    4. Breathing rate and depth will not change since only the renal mechanism can deal with acidosis

  18. The pH of blood varies directly with:
    1. HCO3-
    2. H+
    3. Pco2


  20. If plasma [aldosterone] increases, Na+ excretion will ___________.

  21. If lactic acid is injected iv, then plasma bicarbonate ion levels will immediately ______________.

  22. What is the renal mechanism to correct for respiratory alkalosis?

  23. As a result of the compensation in the above question, what ion imbalance problem might develop? Why?

23)  The primary means of water movement between fluid compartments is:
    A) osmosis.
    B) primary active transport.
    C) secondary active transport.
    D) facilitated diffusion.
    E) pinocytosis.

24)  The direction of water movement between fluid compartments is determined by:
    A) the electrical gradient.
    B) the solubility of water in membrane lipids.
    C) the concentration of solutes.
    D) the diameter of blood vessels.
    E) differences in pH.

25)  Women generally have a lower amount of total body water than men because:
    A) they are smaller than men.
    B) estrogen causes greater water loss than testosterone.
    C) they have a higher body temperature.
    D) they have a higher percentage of body fat.
    E) All of these are correct.

26)  The thirst center is stimulated by ALL of the following EXCEPT :
    A) osmoreceptors in the hypothalamus.
    B) peripheral chemoreceptors.
    C) baroreceptors.
    D) dry mouth.
    E) angiotensin II.

27)  The primary determinant of body fluid volume is the:
    A) concentration of potassium ions inside cells.
    B) level of physical activity.
    C) amount of water ingested.
    D) body weight.
    E) number of sodium and chloride ions lost from the kidney.

28)  The stimulus for release of ANP is:
    A) renin.
    B) ADH.
    C) aldosterone.
    D) stretching of the atrial wall.
    E) osmoreceptors.

29)  A decrease in angiotensin II leads to:
    A) increased blood volume due to decreased GFR.
    B) decreased blood volume due to increased GFR.
    C) decreased blood volume due to decreased GFR.
    D) increased blood volume due to increased GFR.
    E) no changes in blood volume.

30)  The area that stimulates the conscious desire to drink water is located in the:
    A) adrenal cortex.
    B) kidney.
    C) medulla oblongata.
    D) hypothalamus.
    E) lumbar region of the spinal cord.

31)  In studies of fluid balance, the term water  intoxication  refers to:
    A) poisoning of the body's water due to buildup of toxic substances during renal failure.
    B) increased blood hydrostatic pressure created by high total blood volume.
    C) movement of water from interstitial fluid into intracellular fluid due to osmotic gradients created by ion loss.
    D) any situation in which edema develops.
    E) failure of the neurohypophysis to secrete sufficient ADH.

32)  ADH saves water by:
    A) promoting the excretion of sodium ions.
    B) stimulation the secretion of renin.
    C) enhancing passive movement of water out of the collecting ducts.
    D) stimulating constriction of the lumen of the distal convoluted tubules.
    E) lowering the glomerular filtration rate.

33)  Extracellular fluids are:
    A)  High in both sodium and potassium
    B)  Low in both sodium and potassium
    C)  High in sodium and low in potassium
    D)  Low in sodium and high in potassium

34)  Excessive intake or drinking of water normally leads to:
    A)  Hypertonicity of the blood
    B)  Increased permeability of the collecting duct to water
    C)  Decreased blood volume
    D)  Reduced ADH secretion
    E)  All of the answers are correct.

35)  The cation that is necessary for generation and conduction of action potentials and that contributes nearly half of the osmotic pressure of extracellular fluid is:
    A) sodium ion.
    B) potassium ion.
    C) calcium ion.
    D) chloride ion.
    E) phosphate ion.

36)  Levels of sodium ions in the extracellular fluid are regulated primarily by:
    A) ADH.
    B) aldosterone.
    C) parathyroid hormone.
    D) epinephrine.
    E) insulin.

37)  Levels of potassium ions in the extracellular fluid are regulated primarily by:
    A) ADH.
    B) aldosterone.
    C) parathyroid hormone.
    D) epinephrine.
    E) insulin.

38)  The primary intracellular ions are:
    A) potassium and chloride ions and protein anions.
    B) sodium and phosphate ions.
    C) potassium and phosphate ions and protein anions.
    D) sodium and chloride ions.
    E) potassium, phosphate, and calcium ions.

39)  Drinking plain water after excessive sweating leads to:
    A) shut‑down of sweat glands.
    B) hypernatremia.
    C) water intoxication.
    D) dehydration of cells.
    E) both C and D are correct.

40)  Protein anions are most abundant in:
    A) plasma.
    B) interstitial fluid.
    C) the cytosol.
    D) urine.
    E) glomerular filtrate.

41)  When bicarbonate ion diffuses out of red blood cells into plasma, it is usually exchanged with which anion?
    A) sodium
    B) potassium
    C) phosphate
    D) hydrogen
    E) chloride

42)  Hypernatremia can be defined as a(n)
    A)  Reduction of concentration of plasma calcium
    B)  Decrease in plasma potassium
    C)  Increase in plasma phosphate
    D)  Excessive retention of plasma sodium
    E)  All of the answers are correct.

43)  Which of the following would you expect to see in response to an extracellular fluid calcium ion level of 5.7 mEq/liter?
    A) increased secretion of aldosterone.
    B) increased secretion of PTH.
    C) increased secretion of CT.
    D) decreased secretion of ANP. E) increased secretion of ADH.

44)  Bicarbonate ion acts as a:  
    A) nonelectrolyte.  
    B) strong acid.  
    C) strong base.  
    D) weak acid.  
    E) weak base.  

45)  The carboxyl group of an amino acid acts as a buffer for:
    A) excess hydrogen ions.
    B) excess hydroxide ions.
    C) other carboxyl groups.
    D) carbonic acid in red blood cells.
    E) hydrochloric acid in gastric juice.

46)  Why are levels of bicarbonate ion higher in arterial blood than in venous blood?
    A) because the partial pressure of carbon dioxide is higher in arterial blood
    B) because more bicarbonate ions are used up in venous blood to buffer hydrogen ions
    C) because the higher oxygen levels in arterial blood promote dissociation of carbonic acid
    D) because cells in the pulmonary capillaries actively secrete bicarbonate ions into the plasma 
    E) because the higher oxygen levels in arterial blood increase the activity of carbonic anhydrase

47)  Which of the following is NOT an effect of increased levels of parathyroid hormone
    A) increased absorption of calcium ions from the gastrointestinal tract
    B) increased reabsorption of calcium ions by renal tubule cells
    C) increased reabsorption of phosphate ions by renal tubule cells
    D) increased release of calcium ions from mineral salts in bone matrix
    E) increased release of phosphate ions from mineral salts in bone matrix

48)  Hemoglobin picks up a hydrogen ion when:
    A) it releases oxygen to tissues.
    B) it binds oxygen in pulmonary capillaries.
    C) chloride ions enter red blood cells.
    D) the intracellular concentration of monohydrogen phosphate ions is too low to be effective.
    E) chloride ions leave red blood cells.

49)  Which of the following statements is correct?
    A) A strong acid plus a weak acid yields water plus a weak base.
    B) A strong acid plus a weak base yields a salt plus a weak acid.
    C) A strong acid plus a weak base yields a weak base plus a weak acid.
    D) A strong acid plus a strong base yields a weak acid plus a weak base.
    E) A strong acid plus a weak acid yields a strong base plus a weak base.

50)  The ratio of bicarbonate ions to carbonic acid molecules in extracellular fluid is normally about:
    A) 1:20.
    B) 1:1.
    C) 2:1.
    D) 20:1.
    E) 100:1.

51)  Which of the following cannot help protect against pH changes caused by respiratory problems in which there is an excess or shortage of carbon dioxide?
    A) plasma protein buffers
    B) hemoglobin
    C) bicarbonate ion/carbonic acid buffers
    D) phosphate buffers
    E) only phosphate buffers can help protect against such pH changes

52)  An acid may be defined as
    A)  A donor of hydrogen
    B)  An acceptor of hydrogen
    C)  A material that is completely dissociated
    D)  A material that is not completely dissociated.

53)  If the blood is acidic, which one of the following would NOT occurs?
    A)  Ammonia would be secreted by the cells of the kidney tubules
    B)  The personís rate of breathing would increase
    C)  Sodium ions would be taken up by the kidneys
    D)  Hydrogen ions would be excreted by the kidneys.
    E)  All of the answers are correct.

54)  A pH of 6.5 is said to be
    A)  Alkaline
    B)  Acid
    C)  Neutral

55)  Holding your breath for an extended period of time results in
    A)  Respiratory acidosis
    B)  Respiratory alkalosis
    C)  Metabolic acidosis
    D)  Metabolic alkalosis

56)  Hyperventilation results in
    A)  Metabolic acidosis
    B)  Respiratory acidosis
    C)  Metabolic alkalosis
    D)  Respiratory alkalosis

57)  In compensating for respiratory alkalosis, the body excretes more:
    A) ammonium ions.
    B) bicarbonate ions.
    C) dihydrogen phosphate ions.
    D) carbonic acid.
    E) hydrogen ions.

58)  An increase in ADH leads to:
    A) insertion of aquaporin‑2 channels into principal cell membranes.
    B) an increase in aldosterone.
    C) stimulation of the thirst center.
    D) excretion of bicarbonate ions.
    E) Both A and C are correct.

59)  Which of the following statements is correct?
    A) A strong base plus a weak base yields a salt plus a weak base.
    B) A strong base plus a weak acid yields a strong acid and a weak base.
    C) A strong base plus a strong acid yields a weak base plus a weak acid.
    D) A strong base plus a weak acid yields water plus a weak base.
    E) A strong base plus a weak base yields a strong acid plus a weak acid.

60)  The inspiratory center in the medulla oblongata triggers more forceful and frequent contractions of the diaphragm if:
    A) a decrease in pC02  is detected by peripheral chemoreceptors.
    B) a large quantity of an alkaline drug is ingested.
    C) levels of ketone bodies become elevated.
    D) hydrochloric acid is lost via severe vomiting.
    E) blood pressure is increased.

61)  Hydrogen ions are normally eliminated from the body:
    A) by excretion in urine.
    B) via insensible perspiration.
    C) in expired air.
    D) both A and B are correct.
    E) both A and C are correct.

62)  A person who has not eaten for a week is probably:
    A) generating ketone bodies.
    B) excreting excess hydrogen ions.
    C) generating new bicarbonate ions.
    D) breathing more rapidly than normal.
    E) All of these are correct.

63)  In compensating for metabolic acidosis, the body:
    A) increases respiratory rate.
    B) excretes more bicarbonate ions.
    C) excretes more monohydrogen phosphate ions.
    D) decreases respiratory rate.
    E) slows the rate of conversion of ammonia to urea.

64)  If the pH of blood plasma becomes 7.49 due to ingested substances, ALL of the following would happen to compensate EXCEPT :
    A) respiratory rate decreases.
    B) the kidney increases excretion of bicarbonate ions.
    C) tubule cells produce more ammonia from glutamate.
    D) the partial pressure of carbon dioxide in blood would begin to rise.
    E) the kidney excretes fewer dihydrogen phosphate ions.

65)  Aldosterone regulates the level of chloride ions in body fluids by:
    A) opening chloride channels in principal cells of distal convoluted tubules.
    B) reabsorbing chloride ions for electrical balance as bicarbonate ions are       secreted from renal tubules.
    C) altering the permeability of glomerular capillaries.
    D) regulating secretion from gastric mucosal glands.
    E) controlling reabsorption of sodium ions, which chloride ions follow due to electrical attraction.

66)  Increasing respiratory rate will:
    A) add more hydrogen ions to the extracellular fluid.
    B) result in an increase in excretion of excess bicarbonate ions in urine.
    C) result in an increase in excretion of dihydrogen phosphate ions in urine.
    D) lower the pH of extracellular fluid.
    E) cause a decrease in the affinity of hemoglobin for oxygen.

67)  Uncontrolled diabetes mellitus may lead to metabolic acidosis because:
    A) high glucose levels depress the respiratory centers in the medulla.
    B) glucose is an acidic substance.
    C) glucose is osmotically active, and for every water molecule retained, a hydrogen ion is also retained. 
    D) most diabetics have chronic diarrhea, which leads to excessive loss of bicarbonate ions.
    E) increased rated of lipolysis and ketogenesis occur.

68)  Which of the following might trigger an increase in the rate of deamination of glutamine by renal tubule cells as a form of compensation for a pH imbalance?
    A) an abrupt move to a high altitude
    B) ingestion of alkaline drugs
    C) plasma levels of bicarbonate ion at 30 mEq/liter
    D) pulmonary edema
    E) severe, prolonged vomiting

69)  A patient whose blood pH is 7.47, whose pCO2  is 31 mmHg in arterial blood, and whose levels of bicarbonate ion in arterial blood are 23 mEq/liter is in:
    A) compensated metabolic alkalosis.
    B) uncompensated respiratory acidosis.
    C) uncompensated respiratory alkalosis.
    D) uncompensated metabolic acidosis.
    E) uncompensated metabolic alkalosis.

70)  The most abundant buffer intracellular fluid system is
    A)  Proteins
    B)  Phosphates
    C)  Bicarbonates
    D)  Ammonium
    E)  All answers are equal

71)  Use of laxatives in older people to relieve constipation often results in
    A)  Hyponatremia
    B)  Hypokalemia
    C)  Hypernatremia
    D)  Hypocalcemia.

72)  Edema may result from
    A)  Hypoproteinemia
    B)  Lymphatic blockage
    C)  Increased blood hydrostatic pressure
    D)  All of the above are correct.


A) Hypocalcemia
B) Hyponatremia
C) Hypernatremia
D) Hyperkalemia
E) Hypokalemia

73.  Excess sodium

74.  Depletion of sodium

75.  Calcium depletion

76.  Excess potassium



A)  Aldosterone
B)  Parathyroid hormone
C)  Insulin
D)  Antidiuretic hormone
E)  Glucocorticoid

77.  Water control in collecting duct  
78.  Controls calcium 
79.  Controls sodium 
80.  Controls glucose



A)  Metabolic acidosis

B)  Respiratory alkalosis
C)  Metabolic alkalosis
D)  Respiratory acidosis

81.  Excessive vomiting with substantial loss of HCL 
82.  Accumulation of acids like ketosis 

83.  Hyperventilation
84.  Results from emphysema



A)  Sodium
B)  Potassium
C)  Chloride
D)  Calcium
E)  Sulfate

85. Highest cation intracellularly  
86. Highest cation extracellularly 
87. Highest cation in plasma 
88. Highest anion extracellularly



A)  Phosphate
B)  Chloride
C)  Calcium
D)  Magnesium
E)  Sodium

89.  Most common cation in bone 
90.  Most common anion in bone  
91.  Cofactor for sodium pump 

92.  Exchanged across the membrane for bicarbonate



93)  Severe vomiting leads to the pH imbalance __________ due to loss of __________.


94)  Aspirin overdose leads to the pH imbalance __________ due to __________.

95)  You would expect a person with chronic obstructive pulmonary disease to be excreting more __________ in urine than a healthy person.

96)  The physiological response to an acid‑base imbalance that acts to normalize arterial blood pH is called __________.

97)  In the phosphate buffer system, the weak acid is __________ and the weak base is __________.  

98)  The most abundant buffer in intracellular fluid and plasma is the __________ system.

99)  The __________ group of an amino acid acts as an acid.  

100)  Hydrogen ions are buffered inside red blood cells by __________.

101)  Bone resorption is stimulated by the hormone __________ to raise the blood levels of __________ ions.  

102)  The normal range of plasma concentration of bicarbonate ions is __________ in arterial blood; it is slightly __________ in venous blood.  

103)  PTH stimulates __________ of calcium ions from kidney tubules, __________ of phosphate ions, and __________ of magnesium ions.

104)  The level of sodium ions in the blood is controlled by the hormones __________ , __________ , and __________.

105)  The condition resulting when water intake exceeds the kidneys' excretory ability is called __________.  

106)  The thirst center is stimulated by __________ , __________ , and __________.

107)  In a healthy, resting person the greatest loss of water other than urinary loss is by __________.  

108)  The major extracellular fluid compartments are the __________ and __________.

109)  Plasma levels of potassium ions are regulated primarily by the hormone __________.

110)  As age increases, the percentage of body weight that is water __________ ; as the amount of adipose tissue increases, the percentage of body weight that is water __________.

111)  The positive or negative charge equal to the amount of charge in one mole of hydrogen ions is called one __________.

112)  In intracellular fluid, the most abundant cation is __________ and the most abundant inorganic anion is __________.

113)  The most abundant extracellular anion is __________.

114)  As blood passes through the pulmonary capillaries, the plasma level of bicarbonate ion __________.  

115)  The homeostatic range of pH for extracellular fluid is _________ to __________.

116)  When respiratory rate increases, pH of extracellular fluid __________.

117)  A strong acid combined with a weak base yields __________ and __________.  

118)  Describe the fluid and electrolyte disorders to which the elderly are particularly susceptible.

119)  Explain how it is possible for a patient with chronic obstructive pulmonary disease to have a normal extracellular pH while having an elevated partial pressure of carbon dioxide.

120)  A patient's blood pH is 7.48; partial pressure of carbon dioxide is 32 mm Hg and levels of bicarbonate in the blood are 20 mEq/liter. What can you tell about this patient's condition? Explain your answer.

121)  Describe the negative feedback loop that stimulates thirst as a result of dehydration.

122)  What are acidosis and alkalosis, and how do they develop? What are the primary effects of each?


123) Where is most water found in the body?
A) blood plasma
B) whole blood
C) tissue spaces
D) in cells
124) Which of these is a transcellular fluid?
A) plasma
B) lymph
C) interstitial
D) synovial
125) Which of these is not a transcellular fluid?
A) interstitial fluid
B) vitreous humor
C) peritoneal fluid
D) mucus
126) Which of these is relatively high in extracellular fluids?
A) potassium
B) calcium
C) phosphate
D) sodium
127) What is the main force that causes water to move among the various fluid compartments?
A) osmosis
B) filtration
C) hydrostatic pressure
D) dialysis
128) What is the main force that causes fluid to leave the plasma compartment?
A) osmosis
B) hydrostatic pressure
C) dialysis
D) filtration
129) How is the excess tissue fluid mainly returned to the blood?
A) hydrostatic forces
B) through the capillaries
C) lymphatic vessels
D) tissue osmosis
130) About _____% of the total daily intake of water is derived from internal cell metabolism.
A) 33
B) 10
C) 80
D) 60
131) What is the greatest regulator of water intake?
A) renal function
B) gastrointestinal system
C) adequate diet
D) hypothalamus
132) As total body water decreases, the _____ of the extracellular fluid increases.
A) amount of sodium
B) osmotic pressure
C) hydrostatic pressure
D) protein level
133) The greatest amount of body water is lost through _____.
A) sweating
B) defecation
C) urine
D) breathing
134) The main factor that causes the kidney to conserve water is _____.
B) osmosis
C) renin production
D) plasma filtration pressure
135) ADH is secreted from the _____.
A) hypothalamus
B) posterior pituitary
C) anterior pituitary
D) kidney
136) Which of the following would have a diuretic effect?
A) eating salty pretzels
B) drinking alcohol
C) sleeping
D) most drugs
137) ADH has a direct effect on _____.
A) blood pressure
B) water reabsorption
C) blood concentration
D) all of these
138) Excessive vomiting usually results in the phenomenon of _____.
A) water intoxication
B) dehydration
C) edema
D) hypoproteinemia
139) The symptoms of dehydration result from loss of _____ water.
A) intracellular
B) extracellular
C) blood
D) transcellular
140) The effects of water intoxication are usually related to _____.
A) blood pressure
B) hypoproteinemia
C) low sodium
D) high potassium
141) Which of the following favor the development of edema?
A) hypoproteinemia
B) decreased venous pressure
C) decreased capillary permeability
D) lymphatic flow
142) Which of these is not a usual cause of hypoproteinemia?
A) glomerulonephritis
B) poor diet
C) diuresis
D) liver disease
143) What can be a direct cause of ascites?
A) hypertension
B) hepatic disease
C) glomerulonephritis
D) renal failure
144) What causes the edema seen in inflammations?
A) hyperproteinemia
B) histamine
C) hypertension
D) cell damage
145) Which of the following is not true in Addison's disease?
A) sodium decreases
B) potassium decreases
C) adrenal cortex failure
D) low aldosterone
146) Where are most electrolytes normally lost?
A) feces
B) sweating
C) urine
D) respiration
147) What is the most abundant extracellular cation?
A) potassium
B) Mg2+
C) chloride
D) sodium
148) Which factor accounts for the ability of the body to conserve high levels of sodium?
A) blood pressure
B) aldosterone
C) kidney function
D) adequate diet
149) Which ion is usually exchanged for sodium absorption?
A) Cl-
B) bicarbonate
C) K+
D) H+
150) Which cells are most sensitive to electrolyte changes?
A) osteoblasts
B) epithelial
C) leukocytes
D) neurons
151) Which of these is not an effect of parathyroid hormone?
A) osteoclast stimulation
B) increase in blood Ca2+
C) increase in renal elimination
D) increase in intestinal absorption
152) Which ion is directly related to calcium homeostasis?
A) Mg2+
B) sodium
C) phosphate
D) chloride
153) Hyperparathyroidism usually causes an increase in _____.
A) potassium
B) calcium
C) phosphate
D) sodium
154) Which of the following does not become involved with maintaining blood calcium balance?
A) skeletal muscle
B) bone
C) kidneys
D) intestine
155) Which of the following is not related to hypocalcemia?
A) vitamin D deficiency
B) muscle weakness
C) tetany
D) cardiac arrhythmia
156) Which is the most abundant extracellular ion?
A) phosphate
B) bicarbonate
C) chloride
D) potassium
157) What is the most important ion, which affects all of the functions of the others?
A) H+
B) Na+
C) K+
D) phosphate
158) Which of the following will not produce H+ ions?
A) respiration of glucose
B) oxidation of fatty acids
C) synthesis of phosphoproteins
D) oxidation of sulfur amino acids
159) Which of these is not associated with acidity?
A) H3PO4
B) lactic
C) ketone
D) glucose
160) What is a likely cause of hypernatremia?
A) high salt in the diet
B) kidney failure
C) diabetes insipidus
D) vomiting
161) Hypokalemia could result from all of these except which one?
A) vomiting
B) Addison's disease
C) Cushing's disease
D) renal failure
162) Which of the following acts as a base in body fluids?
A) H+
B) HCl
C) H2CO3
D) HCO3-
163) Which of the following does not play a significant role in maintaining acid-base balance?
A) blood buffers
B) stomach
C) kidney
D) respiration
164) Which of the following could act as a buffer?
A) bicarbonate ion
B) H2PO4
C) albumin
D) carbonic acid
165) The purpose of a buffer system is to _____.
A) prevent pH changes
B) increase acidity
C) decrease pH
D) maintain a pH range
166) In the bicarbonate buffer system, _____ reacts with bases.
A) carbon dioxide
B) carbonic acid
C) bicarbonate ion
D) water
167) When a strong base reacts with the bicarbonate buffer system, ______ is formed from the base.
A) water
B) carbon dioxide
C) bicarbonate ion
D) carbonic acid
168) When an acid reacts with the bicarbonate buffer system, ______ is formed as an end product.
A) NaCl
B) water
C) carbonic acid
D) bicarbonate ion
169) What happens to HCl in the phosphate buffer reaction?
A) ionizes
B) forms water
C) forms H2PO4
D) forms a weak acid and salt
170) What reacts with excess acids in protein buffers?
A) carboxyl group
B) amino group
C) CO2
D) NH3+
171) What reacts with the excess bases in protein buffers?
A) NH2
B) carbon dioxide
C) NH3+
D) carboxyl group
172) What buffers the addition of hydrogen in blood cells following the uptake of carbon dioxide?
A) albumin
B) bicarbonate
C) hemoglobin
D) phosphate
173) Which factor greatly increases the reaction between carbon dioxide and water?
A) carbonic anhydrase
B) concentration of carbon dioxide
C) concentration of bicarbonate
D) pH of hemoglobin
174) Which of the following is an effect of acidosis?
A) increased diuresis
B) decreased diuresis
C) mental confusion
D) seizures
175) Which blood parameter is directly affected by breathing?
A) blood pH
B) carbon dioxide
C) bicarbonate levels
D) buffer chemicals
176) During periods of acidosis, the kidney will secrete _____ into the urine.
A) carbon dioxide
B) K+
C) H2PO4
177) In an attempt to remove acid from the blood, the kidneys will secrete _____ into the urine compartment.
A) ammonia
B) NH4+
C) chloride
D) monohydrogen phosphate
178) Which mechanism requires the most time to regulate pH?
A) bicarbonate buffer
B) phosphate buffer
C) respiration
D) renal function
179) Which condition is a generalized accumulation of body edematous tissues?
A) azotemia
B) anuria
C) acetonemia
D) anasarca
180) What is the normal pH of the blood?
A) 7.40-7.50
B) 7.35-7.45
C) 6.8-7.9
D) 7.0-8.0
181) What is the pH range compatible with life?
A) 7.35-7.45
B) 7.0-9.0
C) 6.8-8.0
D) 5-9
182) Hyperventilation from anxiety usually causes _____.
A) respiratory acidosis
B) metabolic acidosis
C) respiratory alkalosis
D) metabolic alkalosis
183) Lung cancer usually causes the tendency towards _____.
A) metabolic acidosis
B) metabolic alkalosis
C) respiratory acidosis
D) respiratory alkalosis
184) Cerebrospinal fluid, fluid within the eyes, joints, and body cavities, and fluid secretions of exocrine glands are all classified specifically as ______________ fluid.
A) intracellular
B) extracellular
C) transcellular
D) None of the above
185) What are the two major factors that regulate the movement of water and electrolytes from one fluid compartment to the next?
A) hydrostatic pressure and osmotic pressure
B) sodium concentration and osmotic pressure
C) hydrostatic pressure and potassium concentration
D) concentration of all electrolytes combined and water pressure
186) What trigger signals the brain to increase the output of ADH for water conservation?
A) thickened saliva signals the sympathetic nervous system
B) osmoreceptors in the hypothalamus detect the increase in osmotic pressure of body fluids and signal the posterior pituitary to release ADH
C) chemoreceptors in the renal tubule sense the increased viscosity of renal filtrate and signal the hypothalamus which, in turn, signals the posterior pituitary
D) the juxtaglomerular apparatus senses the greater osmotic pressure in the blood and triggers the release of ADH
187) How does alcohol function as a diuretic?
A) Alcohol dilutes the blood and thus enables increased urine output.
B) Alcohol receptors in the liver sense its presence and trigger a biochemical pathway that increases urine output to rid the body of alcohol.
C) Alcohol inhibits the release of ADH and thus urine output is increased.
D) Alcohol prevents the distal convoluted tubule from reabsorbing water from the filtrate.


188) A so-called "salt craving" is primarily the result of _________________.
A) a learned behavior
B) a genetic disease
C) dehydration
D) a severe electrolyte deficiency
189) _______________ ions account for nearly 90% of the positively charged ions found in extracellular fluid.
A) Potassium
B) Calcium
C) Sodium
D) Sulfate
190) The hormone aldosterone regulates the concentrations of _____________ and ______________ in the body.
A) potassium ions; sodium ions
B) calcium ions; phosphate ions
C) calcium ions; chloride ions
D) phosphate ions; sulfate ions
191) Edema can be caused by all of these factors except ________________.
A) an increase in the plasma protein concentration
B) obstruction of lymphatic vessels
C) increased capillary permeability because of inflammation
D) increased venous pressure
192) The imbalance known as ____________ can be caused by certain diuretic medications.
A) hyponatremia
B) hypernatremia
C) hypokalemia
D) hyperkalemia
193) Which of the following does not occur as a result of a shift in the acid- base balance of the body?
A) an alteration in the rate of enzyme-controlled metabolic reactions
B) an increase in metabolic efficiency within the cells
C) a shift in the distribution of other ions
D) a modification in hormone actions
194) Choose the factor that is not a major metabolic source of hydrogen ions in the body.
A) aerobic and anaerobic respiration of glucose
B) oxidation of amino acids that contain sulfur
C) hydrolysis of phosphoproteins
D) dehydration synthesis of nucleic acids
195) The three most important buffer systems in body fluids include the bicarbonate buffer system, the ______________ buffer system, and the protein buffer system.
A) calcium
B) sodium
C) phosphate
D) hemoglobin
196) How is it possible for the rate and depth of breathing to affect hydrogen ion concentrations in body fluids?
A) During increased air exchange, more oxygen is exchanged with body cells, binding hydrogen ions.
B) During increased air exchange, more carbon dioxide is given off, returning hydrogen ion concentrations to normal.
C) During increased respiration over the long term, more hemoglobin is produced, thus increasing the buffering of the blood
D) The rate and depth of breathing does not alter hydrogen ion concentration in body fluids.
197) Which of these is considered a secondary defense against changes in pH?
A) renal excretion of hydrogen ions
B) the bicarbonate buffer system
C) the phosphate buffer system
D) the protein buffer system
198) The accumulation of nitrogenous wastes in the blood is a condition known as ________________.
A) ketonuria
B) proteinuria
C) azotemia
D) acetonuria
199) Which body compartment contains the greatest relative amount of water?
A) extracellular
B) intracellular
C) plasma
D) transcellular
200) _____is the most common extracellular cation, while _____ is the most abundant intracellular cation.
A) Sodium; Ca++
B) K+; Na+
C) Sodium; potassium
D) K+; Ca++
201) Which of these values would be the smallest?
A) metabolic water
B) water output
C) water in food
D) water in beverages
202) Which of these conditions leads to a severe, life- threatening water loss?
A) diabetes mellitus, type 1
B) diabetes mellitus, type 2
C) diabetes insipidus
D) hyponatremia
203) An abnormal accumulation of interstitial fluid is termed ______.
A) inflammation
B) necrosis
C) hypoproteinemia
D) edema
204) The most serious consequence of potassium imbalances is _____.
A) seizure
B) nerve damage
C) renal failure
D) cardiac abnormalities
205) What is the normal pH of the blood?
A) 7-8
B) 7.35-7.45
C) 7.10-7.50
D) 7.3-7.4
206) Under normal circumstances, _________ is probably the greatest source of H+.
A) carbon dioxide
B) lactic acid
C) oxidation of fatty acids
D) hydrolysis reactions
207) What is the most significant inorganic plasma buffer?
A) phosphate
B) albumin
C) hemoglobin
D) bicarbonate
208) What is the most effective intracellular inorganic buffer?
A) bicarbonate
B) phosphate
C) hemoglobin
D) lactate
209) Which of the following is the most toxic?
A) urea
B) NH3
C) NH4+
D) carbonic acid
210) Diabetic ketoacidosis is an example of which imbalance?
A) respiratory acidosis
B) respiratory alkalosis
C) metabolic alkalosis
D) metabolic acidosis
211) Which of the following is not likely to cause acidosis?
A) lung cancer
B) fever
C) renal failure
D) diarrhea
212) What is the term for a condition of widespread edema?
A) anasarca
B) anuria
C) uremia
D) ketonuria
213) Which of these is not a consequence of vomiting?
A) dehydration
B) metabolic acidosis
C) respiratory alkalosis
D) metabolic alkalosis


214) Renal secretion of phosphate acids is an example of renal compensation for respiratory acidosis.
  A) True
  B) False
215) A pH of 7.1 in a diabetic is caused by the production of compounds such as beta-hydroxybutyric acid.
  A) True
  B) False
216) Vomiting can result in either metabolic acidosis or alkalosis.
  A) True
  B) False
217) Metabolic alkalosis could develop in persons being treated for peptic (gastric) ulcers.
  A) True
  B) False
218) Persons who are obese usually have a higher percentage of body fat than those who are leaner.
  A) True
  B) False
219) High concentrations of blood sodium could cause tissue cells to expand from taking in excess water.
  A) True
  B) False
220) Erythrocytes will swell in a hypotonic solution.
  A) True
  B) False
221) During the drinking of water, the stretching of the stomach causes a hypothalamic reflex to send an impulse to the nervous system causing the person to stop.
  A) True
  B) False
222) The osmoreceptors in the hypothalamus cannot detect the change in body fluids until the loss is decreased to around 20% of body water.
  A) True
  B) False
223) The ability to sweat is the major method of regulating body water and concentration.
  A) True
  B) False
224) Loss of blood from trauma will usually reduce the amount of urine that is produced.
  A) True
  B) False
225) Diuretics can have an effect of reducing blood pressure.
  A) True
  B) False
226) Drinking water can cause intoxication with symptoms similar to alcohol.
  A) True
  B) False
227) Edema caused by surgical procedures or inflammation is always serious and must be treated.
  A) True
  B) False
228) Diuretics could be used to reduce the edema seen in the legs or sacral regions.
  A) True
  B) False
229) Surgical removal of a breast can cause edema in the arm.
  A) True
  B) False
230) Most of the requirement for electrolytes can be adequately met by drinking water.
  A) True
  B) False
231) Cells attempt to maintain electrical charge stability by transporting ions such as sodium inward as soon as they are lost from the cell.
  A) True
  B) False
232) Breast, lung or bone cancers can cause hypercalcemia.
  A) True
  B) False
233) Increases in carbon dioxide production usually result in a decrease in acidity.
  A) True
  B) False
234) The oxidation of fatty or amino acids always must cause a decrease in pH.
  A) True
  B) False
235) Factors that decrease the pH of a solution, must always increase the acidity.
  A) True
  B) False
236) Diuretics have a higher probability of causing a sodium rather than a potassium depletion.
  A) True
  B) False
237) Either hyperkalemia or hypokalemia could be associated with muscle paralysis or cardiac arrhythmias.
  A) True
  B) False
238) Carbonated beverages usually have a higher pH than stomach secretions.
  A) True
  B) False
239) Both components of the phosphate buffer system are acids, which breaks the normal buffering rules.
  A) True
  B) False
240) Holding one's breath tends to make the blood more acidic.
  A) True
  B) False
241) The respiratory centers in the pons and medulla are able to alter the pH of the blood.
  A) True
  B) False
242) A person's blood may be alkaline at the same time they are considered to be in acidosis.
  A) True
  B) False

243) If blood plasma becomes more concentrated, the high osmotic pressure will cause neurons (osmoreceptors) to swell.
A) True
B) False


244) The presence of sodium in the blood can be detected by the osmoreceptors of the hypothalamus.
A) True
B) False


245) The phosphate buffer system is more important in extracellular fluids.
A) True
B) False